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Person-centred care – how far should we go?

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Ross 2

AS a pharmacist, I am more person-centred than I have ever been. That’s a consequence of professional experience, life experience and the fact that the phrase ‘person-centred care’ is now one of the mostly commonly used phrases at pharmacy conferences and meetings. As it should be.

But, what I struggle with understanding is where the line (if there is one) is drawn between person-centred care and pandering to the needs of a demanding individual.

One of the challenges we face is that people are becoming more demanding – they are asserting their rights and have high expectations of all sorts of products and services, pharmacy included.

As community pharmacists, we are, in some ways, victims of our own willingness to help people. We rarely take lunches over the course of a 9-hour day, and if we do we are frequently interrupted to give advice, or check a prescription. Meanwhile, counter assistants and dispensers enjoy their one hour away from the fray. The people with most responsibility don’t get a physical or mental rest.

The problem is that customers expect a pharmacy service to be available all day. If the pharmacy is open and the pharmacist unavailable due to being at lunch, you can hear the moans and groans and the disbelief from furious customers. We have let ourselves fall into this situation.

Likewise, somehow we are in the position where customers judge us by the speed at which their prescription is dispensed, while they are content to wait in post office, supermarket and bank queues. Their tolerance in pharmacy is far, far less.

When a repeat prescription is handed in to the GP on Friday night it’s often expect to be ready for collection from the pharmacy on the Monday morning – sooner if it’s been requested online. Are we victims of our own efficiency?

These however are historical issues, nevertheless, I think they need addressing.

What has prompted my interest in gauging the levels to which person-centred care should extend is my recent one-week stint as a locum.

Over the course of the week there were a number of patients who were unhappy with the medicine they received. We had dispensed the item exactly as the prescription required, however, on these occasions we had not dispensed their favoured generic and so they wanted it swapped. Curious, I asked why they had a preference, but didn’t really get any satisfactory answers. I even looked at the different excipients to see if they could be the cause of any issues. I’m none the wiser.

On talking to the rest of the pharmacy team, it was explained that a number of patients had lists of preferred manufacturers for various products – all annotated on the PMR. I remember back in the day when generics became available for the big brands there were many concerned patients who claimed only to get benefit from the branded product.

So, is there anything in this? Do we have any information about differences between generics? Should we be giving people the generics they demand?

Then there are other requests, such as “lactulose in a glass bottle, not the plastic one”. Or, the complaint a pharmacist friend of mine received because the patient had received a different generic which had a bigger box and it would no longer fit in the person’s medicines cupboard.

Where does person-centred care end and pandering begin? Should it?


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